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AAP Statement on Periodontal Treatment and Improvement in Cardiovascular Health

Intensive periodontal treatment may reverse atherosclerosis and reduce cardiovascular risk.

CHICAGO—March 1, 2007—Research presented in a recent paper by Tonetti et al published in the New England Journal of Medicine (NEJM) suggests that intensive periodontal treatment may reverse atherosclerosis by improving elasticity of the arteries, or endothelial function. Findings from previous studies have suggested a link between periodontal disease and atherosclerosis and proposed that periodontal treatment may reduce cardiovascular risk. This study is important because it furthers the understanding of the potential relationship between periodontal disease and cardiovascular disease.

The study examined two groups: a control treatment group and a periodontal treatment group. The control treatment group received supragingival mechanical scaling and polishing, also known as a prophylaxis. According to the study author, the periodontal treatment group underwent four to six hours of scaling and root planing performed by a periodontist, local delivery antimicrobials, and the extraction of hopeless teeth. It is well documented that meticulous scaling and root planing is an essential form of periodontal treatment when compared to supragingival scaling and polishing because the latter is not used to treat periodontitis. This study did not examine the effects of scaling and root planing without local delivery antimicrobials, so the potential added value of local delivery antimicrobials remains unclear. It will be important for future research to examine the cost-benefit analysis of scaling and root planing compared to scaling and root planing and local delivery antimicrobials. In addition, research is necessary to identify how the results of this study would translate when treatment is provided by dental professionals other than periodontists.

According to the American Heart Association, it is estimated that nearly 80 million Americans had one or more forms of cardiovascular disease in 2004. Cardiovascular disease involves a complex interplay of many risk factors. The interesting findings of the Tonetti study support the need for additional research to determine whether the treatment of severe periodontitis could reduce the risk of developing atherosclerosis and cardiovasular events in adults.

Knowledge of the risk factors and possible links to coronary heart disease, such as periodontal disease is the first step towards preventing it. To find out if you are at risk for periodontal disease, please visit the AAP’s Web site at www.perio.org and take a free risk assessment test. To find out if you are at risk for heart disease, visit www.americanheart.org.

NOTE: An article abstract and pay-per-view copy of the New England Journal of Medicine study are available at www.nejm.org.

About the AAP

The American Academy of Periodontology is an 8,000-member association of dental professionals specializing in the prevention, diagnosis and treatment of diseases affecting the gums and supporting structures of the teeth and in the placement and maintenance of dental implants. Periodontics is one of nine dental specialties recognized by the American Dental Association.

For more information, contact the AAP Public Affairs Department at 312/573-3242.

AAP Statement on Periodontal Treatment and Improvement in Cardiovascular Health

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